Abstract
Background: The supply of long-chain polyunsaturated fatty acids (LC-PUFA) during pregnancy and early lactation has been shown to affect cognitive development in preterm infants, but the effect on early neurodevelopment of late-preterm infants has not yet been examined. Aim: To examine the fatty acid composition of late-preterm human milk and identify possible associations between infant LC-PUFA status and perinatal as well as 1-year neurobehavioral outcomes. Methods: Mother’s milk and erythrocytes (RBC) were sampled from 53 Danish late-preterm infants (33-36 weeks of gestation) 1 week and 1 month after delivery, and 3 months corrected age. Fatty acid composition was determined by gas-liquid chromatography. Neurodevelopmental outcomes were assessed by the Nicu Network Neurobehavioral Scale (NNNS) at 1 week and 1 month and the Bayley Scales (BSID-III) at 1 year corrected age. Results: We found that breast-milk content of arachidonic acid (AA) and docosahexaenoic acid (DHA) was similar to reported fatty acid compositions of term human milk. Infant RBC-AA decreased from 1 week to 1 month of age and the size of the decrease was associated with better NNNS-scores at 1 month, specifically on regulation (p=0.03). Infant RBC-AA at 1 month was also associated with a lower 1-year corrected age BSID-III score of receptive language (p=0.05) and fine motor development (p=0.03). Infant RBC-DHA did not decrease significantly after delivery and was not associated with any of the developmental outcomes. Conclusion: Breast-milk LC-PUFA content was reflected in the RBC LC-PUFA status of the infant. Early RBC-AA status was associated with both early and long-term neurobehavioral development, but not in a consistent way.
Highlights
Long-chain polyunsaturated fatty acids (LC-Polyunsaturated Fatty Acid (PUFA)), especially docosahexaenoic acid (C22:6n-3, DHA) and arachidonic acid (C20:4n-6, AA), may affect the development of the infant brain as well as the infant growth pattern both before and after delivery [1,2]
Infants who were breastfed at 3 months corrected age differed from those who were not by the frequency of maternal smoking in pregnancy (50% smokers in the non-breastfeeding group vs. 5.4% in the breastfeeding group, p
At 1 week of age we found no significant associations between the Nicu Network Neurobehavioral Scale (NNNS) scores and RBC LCPUFA, but infant RBC-AA was found to be positively associated with regulation 1 month after delivery (Table 5B)
Summary
Long-chain polyunsaturated fatty acids (LC-PUFA), especially docosahexaenoic acid (C22:6n-3, DHA) and arachidonic acid (C20:4n-6, AA), may affect the development of the infant brain as well as the infant growth pattern both before and after delivery [1,2] These LCPUFAs accumulate in the brain alongside foetal body fat, during the third trimester of pregnancy and the first few months postterm. Formation and adaptation of synaptic functions as well as glial cell production and myelination take place alongside neuronal regression and conversion of the foetal cortical subplate into a mature cortical structure This transition is believed to mediate the simultaneous change in infant neuro-behaviour, e.g. in motor control from primitive reflexes and jerky movements to smooth and volitional motion [5,11]. The supply of long-chain polyunsaturated fatty acids (LC-PUFA) during pregnancy and early lactation has been shown to affect cognitive development in preterm infants, but the effect on early neurodevelopment of late-preterm infants has not yet been examined
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